Factors Associated with Mild Cognitive Impairment among Elderly Filipinos with Type 2 Diabetes Mellitus

Keywords: older persons, mild cognitive impairment, type 2 diabetes mellitus


Objective. This study aims to identify factors associated with mild cognitive impairment (MCI) among elderly Filipinos with Type 2 diabetes mellitus.

Methodology. This is an analytic cross-sectional study involving 133 elderly (≥60 years old) with Type 2 diabetes mellitus consecutively sampled from the General Medicine and Diabetes Clinics of the Philippine General Hospital. Eligible subjects were interviewed to gather demographic and clinical data. Body mass index, waist-hip ratio and mean blood pressure were computed. HBA1c, lipid profile, creatinine and urine proteinuria were tested or recorded if done recently. Dilated fundus examination via indirect ophthalmoscopy and 10-gram monofilament test were performed to detect retinopathy and neuropathy. The Montreal Cognitive Assessment-Philippines tool was administered to detect patients with probable MCI using a cutoff score of ≤21. Multivariate logistic regression analysis was performed to determine the associated factors.

Results. Using MoCA-P tool, MCI has a rate of 45% among elderly Filipino diabetics. Having more than 12 years of education is significantly associated with lower odds of MCI. (OR 0.38 CI 0.18, 0.80, p value 0.010).

Conclusion. The rate of MCI among Filipino elderly diabetics is high. Higher education is associated with lower odds of having MCI. Case-control or prospective cohort studies involving larger sample and non-diabetic population are recommended.


Download data is not yet available.

Author Biographies

Louren Blanquisco, University of the Philippines - Philippine General Hospital
Fellow-in-training, Section of Endocrinology, Diabetes and Metabolism
Joshua Emmanuel Abejero, University of the Philippines-Philippine General Hospital
Resident, Department of Neurosciences
Bonifacio Buno II, University of the Philippines-Philippine General Hospital
Resident, Department of Ophthalmology and Visual Sciences
Laura Trajano-Acampado, University of the Philippines-Philippine General Hospital
Consultant, Section of Endocrinology, Diabetes and Metabolism
Alvin Cenina, University of the Philippines-Philippine General Hospital
Consultant, Department of Neurosciences
Darby Santiago, University of the Philippines-Philippine General Hospital
Consultant, Department of Ophthalmology and Visual Sciences


De la Vega S, Orteza G, Ledesma L. Recommendations on the diagnosis, prevention and management of Alzheimer’s disease, 2nd ed. Philippines: Alzheimer’s Disease Association of the Philippines, 2014.

Cheng G, Huang C, Deng H, Wang H. Diabetes as a risk factor for dementia and mild cognitive impairment: A meta-analysis of longitudinal studies. Intern Med J. 2012;42(5):484-91. PMID: 22372522. https://doi.org/10.1111/j.1445-5994.2012.02758.x.

Gorska-Ciebiada M, Saryusz-Wolska M, Ciebiada M, Loba J. Mild cognitive impairment and depressive symptoms in elderly patients with diabetes: Prevalence, risk factors and comorbidity. J Diabetes Res. 2014;2014:179648. PMCID: PMC4241577. https://doi.org/10.1155/2014/179648.

Lee YJ, Kang HM, Kim NK, et al. Factors associated for mild cognitive impairment in older Korean adults with type 2 diabetes mellitus. Diabetes Metab J. 2014; 38(2):150-7. PMCID: PMC4021302. https://doi.org/ 10.4093/dmj.2014.38.2.150.

Umegaki H, Kawamura T, Kawano N, et al. Factors associated with cognitive decline in elderly diabetics. Dement Geriatr Cogn Disord Extra. 2011; 1(1):1-9. PMID: 22163228. PMCID: PMC3199895. https://doi.org/ 10.1159/000323188.

Umegaki H, Iimuro S, Shinozaki T, et al. Risk factors associated with cognitive decline in the elderly with type 2 diabetes: Baseline data analysis of the Japanese Elderly Diabetes Intervention Trial. Geriatr Gerontol Int. 2012;12(1):103-9. PMID: 22435945. https://doi.org/10.1111/j.1447-0594.2011.00817.x.

Niu MJ, Yin FZ, Liu LX, Fang Y, Xuan XM, Wu GF. Non-high density lipoprotein cholesterol and other risk factors of mild cognitive impairment among Chinese type 2 diabetic patients. J Diabetes Complications. 2013;27(5):443-6. PMID: 23845902. https://doi.org/10.1016/j.jdiacomp.2013.06.001.

Bruce DG, Davis WA, Casey GP, et al. Predictors of cognitive impairment and dementia in older people diabetes. Diabetologia. 2008;51(2):241-8. PMID: 18060658. https://doi.org/10.1007/s00125-007-0894-7.

Verny C, Doucet J, Bauduceau B, et al. Prevalence of cognitive decline and associated factors in elderly type 2 diabetic patients at inclusion in the GERODIAB cohort. Eur Geriatr Med. 2015;6(1):36-40. https:// doi.org/10.1016/j.eurger.2014.10.006.

Abbatecola AM, Lattanzio F, Spazzafumo L, et al. Adiposity predicts cognitive decline in older persons with diabetes: A 2-year follow-up. PLoS One. 2010;5(4):e10333. PMCID: PMC2859057. https://doi.org/10.1371/journal.pone.0010333.

Cukierman-Yaffe T, Gerstein HC, Williamson JD, et al. Relationship between baseline glycemic control and cognitive function in individuals with type 2 diabetes and other cardiovascular risk factors: The action to control cardiovascular risk in diabetes-memory in diabetes (ACCORD-MIND) trial. Diabetes Care. 2009;32(2):221-6. PMID: 19171735. PMCID: PMC2628683. https://doi.org/10.2337/dc08-1153.

Yaffe K, Falvey CM, Hamilton N, et al. Association between hypoglycemia and dementia in a biracial cohort of older adults with diabetes mellitus. JAMA Intern Med. 2013;173(14):1300-6. PMID: 23753199. PMCID: PMC4041621. https://doi.org/10.1001/jamainternmed.2013.6176.

Winblad B, Palmer K, Kivipelto M, et al. Mild cognitive impairment--beyond controversies, towards a consensus: Report of the International Working Group on Mild Cognitive Impairment. J Intern Med. 2004; 256(3):240-6. PMID: 15324367. https://doi.org/10.1111/j.1365-2796.2004.01380.x.

Eshkoor SA, Hamid TA, Mun CY, Ng CK. Mild cognitive impairment and its management in older people. Clin Interv Aging. 2015;10:687-93. PMID: 25914527. PMCID: PMC4401355. https://doi.org/10.2147/CIA.S73922.

Wada-Isoe K, Uemura Y, Nakashita S, et al. Prevalence of dementia and mild cognitive impairment in the rural island town of Ama-cho, Japan. Dement Geriatr Cogn Disord Extra. 2012;2:190–9. PMID: 22719745. PMCID: PMC3379729. https://doi.org/10.1159/000338244.

Nasreddine ZS, Phillips N, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005; 53(4):695-9. PMID: 15817019. https://doi.org/10.1111/j.1532-5415.2005.53221.x.

Dominguez JC, Orquiza MGS, Soriano JR, et al. Adaptation of the Montreal Cognitive Assessment for elderly Filipino patients. East Asian Arch Psychiatry. 2013;23(3):80-5. PMID: 24088400.

Dominguez JC, Soriano JR, Magpantay CD, et al. Early detection of mild Alzheimer’s disease in Filipino elderly: Validation of the Montreal Cognitive Assessment-Philippines (MoCA-P). Adv Alzheimer Dis. 2014;3(4):160-7. https://doi.org/10.4236/aad.2014.34015.

De Guzman MLR. A validation of the hospital anxiety and depression scale in medically ill. Acta Medica Philippina. 2013;47(3):53-61. http://actamedicaphilippina.com.ph/sites/default/files/fulltexts/vol-47-no-3-a-validation.pdf.

Grading diabetic retinopathy from stereoscopic color fundus photographs -- An extension of the modified Airlie House classification. ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991;98(5 Suppl):786-806. PMID: 2062513.

Zhao Q, Roberts RO, Ding D, et al. Diabetes is associated with worse executive function in both Eastern and Western populations: Shanghai Aging Study and Mayo Clinic Study of Aging. J Alzheimers Dis. 2015; 47(1):167–76. PMCID: PMC4617674. NIHMSID: NIHMS726844. https://doi.org/10.3233/JAD-150073.

Van Exel E, de Craen AJ, Gussekloo J, et al. Association between high density lipoprotein and cognitive impairment in the oldest old. Ann Neurol. 2002;51(6):716-21. PMID: 12112077. https://doi.org/10.1002/ana.10220.

Bonarek M, Barbeger-Gataeu P, Letenneur L, et al. Relationships between cholesterol, apolipoprotein E polymorphism and dementia: A cross-sectional analysis from the PAQUID study. Neuroepidemiology. 2000;19(3):141-8. PMID: 10705232.

Singh-Manoux A, Gimeno D, Kivimaki M, Brunner E, Marmot MG. Low HDL-C cholesterol is a risk factor for deficit and decline in memory in midlife: The Whitehall II study. Arterioscler Throm Vasc Biol. 2008;28(8):1556-62. PMID: 18591462. PMCID: PMC2581752. HALMS: HALMS277029.


He Q, Li Q, Zhao J, et al. Relationship between plasma lipids and mild cognitive impairment in the elderly Chinese: A case-control study. Lipids Health Dis. 2016;15(1):146. PMCID: PMC5011904.

Su X, Shang L, Xu Q, et al. Prevalence and predictors of MCI in Xi’an: A community based study among the elders. PLoS ONE.2014; 9(1): e83217. PMID: 24421876. PMCID: PMC3885430. https://doi.org/10.1371/journal.pone.0083217.

How to Cite
Blanquisco, L., Abejero, J. E., Buno II, B., Trajano-Acampado, L., Cenina, A., & Santiago, D. (2017). Factors Associated with Mild Cognitive Impairment among Elderly Filipinos with Type 2 Diabetes Mellitus. Journal of the ASEAN Federation of Endocrine Societies, 32(2), 145. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/418
Original Articles